DSI Security Technology Solutions Service Request Form

DSI Security Technology Solutions Service Request

Please provide the following information to create a service ticket.
Requestor*

First NameLast Name
Customer Ticket or PO Number
Customer Provided Ticket # (DSI will use this for reference and Invoices).
Requestor E-mail*
email of Manager Requesting Service.
Requestor Phone Number*
Phone # of Manager Requesting Service.
Site Point of Contact*

First Name of Contact on Site if MGR not Available.Last Name of Contact on Site if MGR not Available.
Site POC Phone Number*
Phone # of Contact onsite if MGR not Available.
Site Name*
Location Name Please be specific.
Point of contact is available onsite
Mondays Tuesdays Wednesdays
Thursdays Fridays Saturdays Sundays*
During the following hours:(type hours available, Example: 8am-1pm )
Site Address*

Physical Address (NOT BILL TO)

Street Address Line 2

CityState

Zip Code
Upload supporting documents

(Pictures are worth 1000 words, please attach a photo of the issue you are having, i.e. Screen shot, photo of gate, camera or door)
Cancelof
Primary Issue/Problem*
Select Primary Issue/Problem. (Select from the list, be as specific as possible)
Enter your Primary Issue not listed above
Secondary Issue/Problem
Select a Secondary Option If applicable. (Select from the list, be as specific as possible)
System Type*
(Select the type of system needing service)
Device Type*
(Select the type of device needing service)
Brand of Device (if available)
Provide the model of the device needing service
Model Number of Device (if available)
Provide the model of the device needing service
Impact Level to operation*

LOW - Needs fixed but not urgentMILD - Need up soon as possibleHIGH - Urgent, impacting ability to secure the building.URGENT - Mission Critical needs resolve and constant communication.
Lift Required
Select if lift is needed
Please list any details you think would be helpful in finding a solution to this issue.*
(examples, system down after Lightning Strike or you will need a key to access the building the camera is in.)
Actions taken to troubleshoot prior to ticket request*
(Provide the actions/steps used to trouble this issue prior to creating this ticket)
Please enter Emergency Contact information below:
Should be Empty: